Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Gynecology and Obstetrics

Background: Obesity is a widely spread health problem the complications of which are too many whether general or obstetric complications. Methods: In this prospective observational study, a total of 232 pregnant ladies were included. They were divided into two groups to compare the degree of intra-abdominal adhesions between women with BMI less than 30 kg/m² (group 1) and those with BMI more than or equal to 30 kg/m² (group 2). We also subdivided group 2 candidates into 3 subgroups to compare different degrees of adhesions among them: {uF0B7} Group 2a: women with BMI between 30-35. {uF0B7} Group 2b: women with BMI between 35-40. {uF0B7} Group 2c: women with BMI more than 40. BMI of pregnant women was calculated on admission, preoperative hemoglobin was measured for each patient, the degree of adhesion intra-operative was observed according to Tulandi classification of adhesions. Bladder & bowel injuries were recorded. Post-operative hemoglobin for each case was measured. Results: The current study showed increased incidence of omental adhesions and adhesions between the uterus and abdominal fascia in group 2 more than group 1 but regarding adhesions between uterus & bladder and adhesions to other pelvic organs, the results were similar in both group. Women with BMI more than or equal to 30 kg/m² are at higher risk of hemoglobin drop during CS compared to those with BMI less than 30 kg/m². Bladder and bowel injuries were also similar in both groups

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